Organization
FAMILY HEALTH CARE CENTER
Active
Parent organization
FAMILY HEALTH CARE CENTER
Other names
Family HealthCare South
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY HEALTH CARE CENTER
Authorized official
KRISTIN RENZ-JOHNSON (MANAGER REVENUE CYCLE)
(701) 271-1494
Entity
Organization
Contact information
Practice address
4025 9TH AVE S, FARGO, ND 58103-2101
(701) 271-3344
Mailing address
301 NP AVE N, FARGO, ND 58102-4835
(012) 713-3447
(701) 551-7533
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1472788
—
ND
Enumeration date
10/17/2017
Last updated
04/03/2024
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